MARCO AURELIO SANTO
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Gastroenterologia, Faculdade de Medicina - Docente
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
LIM/35 - Laboratório de Nutrição e Cirurgia Metabólica do Aparelho Digestivo, Hospital das Clínicas, Faculdade de Medicina
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
LIM/35 - Laboratório de Nutrição e Cirurgia Metabólica do Aparelho Digestivo, Hospital das Clínicas, Faculdade de Medicina
68 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 68
conferenceObject CRITICAL ANALYSIS OF THE TECHNIQUES OF SURGICAL TREATMENT OF OBESITY AND ITS CLINICAL IMPLICATIONS(2014) ZILBERSTEIN, B.; SANTO, M. A.; CARVALHO, M. H.; CECCONELLO, I.; KAPPAZ, G. T.; CARVALHO, I. T. I.conferenceObject ANALYSIS OF LIVER FUNCTION IN THE OBESE PATIENT AND ITS CORRELATION WITH METABOLIC COMORBIDITIES NASH and bariatric surgery(2019) SILVA, M. B. D. B. E.; MESQUITA, G. H. A. D.; MOTA, F. C.; KAWAMOTO, F. M.; DANTAS, A. C. B.; MARSON, A. G.; MATSUDA, M.; ANDRAUS, W.; SANTO, M. A.- Exercise Enhances the Effect of Bariatric Surgery in Markers of Cardiac Autonomic Function(2021) GIL, Saulo; PECANHA, Tiago; DANTAS, Wagner S.; MURAI, Igor Hisashi; MEREGE-FILHO, Carlos Alberto Abujabra; SA-PINTO, Ana Lucia de; PEREIRA, Rosa Maria Rodrigues; CLEVA, Roberto de; SANTO, Marco Aurelio; REZENDE, Diego Augusto Nunes; KIRWAN, John P.; GUALANO, Bruno; ROSCHEL, HamiltonBackground Bariatric surgery improves cardiovascular health, which might be partly ascribed to beneficial alterations in the autonomic nervous system. However, it is currently unknown whether benefits from surgery on cardiac autonomic regulation in post-bariatric patients can be further improved by adjuvant therapies, namely exercise. We investigated the effects of a 6-month exercise training program on cardiac autonomic responses in women undergoing bariatric surgery. Methods Sixty-two women eligible for bariatric surgery were randomly allocated to either standard of care (control) or an exercise training intervention. At baseline (PRE) and 3 (POST3) and 9 (POST9) months after surgery, we assessed chronotropic response to exercise (CR%; i.e., percentage change in heart rate from rest to peak exercise) and heart rate recovery (HRR30s, HRR60s, and HRR120s; i.e., decay of heart rate at 30, 60, and 120 s post exercise) after a maximal exercise test. Results Between-group absolute changes revealed higher CR% (Delta = 8.56%, CI95% 0.22-19.90, P = 0.04), HRR30s (Delta = 12.98 beat/min, CI95% 4.29-21.67, P = 0.01), HRR60s (Delta = 22.95 beat/min, CI95% 11.72-34.18, P = 0.01), and HRR120s (Delta = 34.54 beat/min, CI95% 19.91-49.17, P < 0.01) in the exercised vs. non-exercised group. Conclusions Our findings demonstrate that exercise training enhanced the benefits of bariatric surgery on cardiac autonomic regulation. These results highlight the relevance of exercise training as a treatment for post-bariatric patients, ensuring optimal cardiovascular outcomes.
- Sequential Endoscopic Therapies for Treatment of Complex Gastrointestinal Transmural Leak Following Bariatric Surgery(2022) BESTETTI, Alexandre Moraes; SANTO, Marco Aurelio; TRASOLINI, Roberto Paolo; FREITAS JUNIOR, Joao Remi de; HIRSCH, Bruno Salomao; MOURA, Eduardo Guimaraes Hourneaux de; MOURA, Diogo Turiani Hourneaux de
- Endoscopic Treatment of Weight Regain Following Roux-en-Y Gastric Bypass: a Systematic Review and Meta-analysis(2018) BRUNALDI, Vitor Ottoboni; JIRAPINYO, Pichamol; MOURA, Diogo Turiani H. de; OKAZAKI, Ossamu; BERNARDO, Wanderley M.; GALVO NETO, Manoel; CAMPOS, Josemberg Marins; SANTO, Marco Aurelio; MOURA, Eduardo G. H. deRoux-en-Y gastric bypass (RYGB) is the most commonly performed bariatric procedure. Despite its high efficacy, some patients regain part of their lost weight. Several endoscopic therapies have been introduced as alternatives to treat weight regain, but most of the articles are relatively small with unclear long-term data. To systematically assess the efficacy of endoscopic therapies for weight regain after RYGB. We searched MEDLINE, EMBASE, Scopus, Web of Science, Cochrane, OVID, CINAHL/EBSCo, LILACS/Bireme, and gray literature. Primary outcomes were absolute weight loss (AWL), excess weight loss (EWL), and total body weight loss (TBWL). Thirty-two studies were included in qualitative analysis. Twenty-six described full-thickness (FT) endoscopic suturing and pooled AWL, EWL, and TBWL at 3 months were 8.5 +/- 2.9 kg, 21.6 +/- 9.3%, and 7.3 +/- 2.6%, respectively. At 6 months, they were 8.6 +/- 3.5 kg, 23.7 +/- 12.3%, and 8.0 +/- 3.9%, respectively. At 12 months, they were 7.63 +/- 4.3 kg, 16.9 +/- 11.1%, and 6.6 +/- 5.0%, respectively. Subgroup analysis showed that all outcomes were significantly higher in the group with FT suturing combined with argon plasma coagulation (APC) (p < 0.0001). Meta-analysis included 15 FT studies and showed greater results. Three studies described superficial-thickness suturing with pooled AWL of 3.0 +/- 3.8, 4.4 +/- 0.07, and 3.7 +/- 7.4 kg at 3, 6, and 12 months, respectively. Two articles described APC alone with mean AWL of 15.4 +/- 2.0 and 15.4 +/- 9.1 kg at 3 and 6 months, respectively. Full-thickness suturing is effective at treating weight regain after RYGB. Performing APC prior to suturing seems to result in greater weight loss. Head-to-head studies are needed to confirm our results. Few studies adequately assess effectiveness of other endoscopic techniques.
- Sleeve Gastrectomy Versus Roux-en-Y Gastric Bypass in the Elderly: 1-Year Preliminary Outcomes in a Randomized Trial (BASE Trial)(2021) PAJECKI, Denis; DANTAS, Anna Carolina Batista; TUSTUMI, Francisco; KANAJI, Ana Lumi; CLEVA, Roberto de; SANTO, Marco AurelioPurpose Despite the increasing prevalence of elderly obese patients, bariatric surgery remains controversial in this population. Recent publications have focused on perioperative safety, but few studies have addressed clinical outcomes. Objectives This study aimed to evaluate 1-year outcomes of laparoscopic sleeve gastrectomy (LSG) compared to laparoscopic Roux-en-Y gastric bypass (LRYGB) in patients 65 years or older. Methods Thirty-six elderly obese patients were recruited for an open-label randomized trial from September 2017 to May 2019, comparing LSG to LRYGB. One-year outcomes were evaluated based on weight loss, functionality, and control of clinical conditions. Results The median age (67 x 67 years; p=0.67) and initial body mass index (BMI) (46.3 x 51.3 kg/m(2); p=0.28) were similar between groups. Preoperative BMI (after weight loss pre-operative treatment) was higher in LRYGB group (41.9 x 47.6 kg/m(2); p= 0.03). After 12 months, EWL and TWL were higher in LRYGB group (60 x 68%; p=0.04; 24.9 x 31.4%; p<0.01). HbA1c reduction was higher after LRYGB (-1.1 x -0.5%; p<0.01) as well as LDL control (-27.5 x +11.5 mg/dL p= 0.02). No difference was noted between LRYGB and LSG concerning hypertension control, triglycerides, HDL, and functionality. Conclusion Weight loss, diabetes, and LDL control were better achieved with LRYGB after 12 months.
conferenceObject RESTING METABOLIC RATE AND WEIGHT LOSS AFTER BARIATRIC SURGERY Integrated Health/Multidisciplinary care(2017) MOTA, F.; CLEVA, R.; GADDUCCI, A.; CARDIA, L.; GREVE, J.; SILVA, P. R.; SANTO, M. A.conferenceObject ROBOTIC-ASSISTED REVISIONAL ROUX-EN-Y GASTRIC BYPASS FOR LARGE HIATAL HERNIA AND MASSIVE INTRATHORACIC SLEEVE MIGRATION(2023) SANTO FILHO, Marco Aurelio; DANTAS, Anna Carolina Batista; ARABI, Arthur Youssif Mota; PAJECKI, Denis; SANTO, Marco AurelioconferenceObject FREQUENCY AND PERSISTENCE OF PSYCHIATRIC DISORDERS AMONG SEVERELY OBESE PATIENTS: COMORBIDITY BETWEEN MOOD, ANXIETY, AND EATING DISORDERS(2016) Duarte-Guerra; COELHO, B. M.; SANTO, M. A.; LOTUFO-NETO, F.; WANG, Y. P.- Levothyroxine Absorption in Morbidly Obese Patients Before and After Roux-En-Y Gastric Bypass (RYGB) Surgery(2012) RUBIO, Ileana Gabriela Sanchez; GALRAO, Ana Luiza; SANTO, Marco Aurelio; ZANINI, Antonio Carlos; MEDEIROS-NETO, GeraldoRoux-en-Y gastric bypass (RYGB) modifies the anatomical structure of the upper intestine tract, reduces gastric acid secretion, and may impair LT4 absorption. The aim of this study was to evaluate the LT4 absorption in morbidly obese patients before and after RYGB. Thirty morbidly obese patients were divided in two groups: The NS group included 15 patients before RYGB surgery (BMI = 43.1 +/- 4 kg/m(2)), and the S group included 15 patients after surgery (BMI = 37.3 +/- 4 kg/m(2)). Two baseline samples were collected, and 600 mu g of oral LT4 tablets were administered. Blood samples were collected at 30, 60, 120, 180, 240, 300, and 1440 min. Serum-free T4 (FT4), total T4 (TT4), and TSH were measured at each time point. The increase in TT4, FT4, and TSH (Delta TT4, Delta FT4, and Delta TSH) was calculated, subtracting from the baseline mean value. The pharmacokinetics parameters regarding LT4 absorption, maximum Delta TT4, and area under the curve(AUC) of both Delta TT4 and Delta FT4 were significantly higher in the S group compared with the NS group (p < 0.05). It was observed, however, that there was a significant delay in the absorption of LT4 in the S group. Basal serum TSH and leptin levels were higher in the NS group (p = 0.016 and 0.026, respectively), whereas basal serum TT4, FT4, Delta TSH, and the AUC of Delta TSH were similar between groups. In this study, we have demonstrated that Roux-en-Y bypass surgery does not diminish LT4 absorption. A small but significant delayed absorption of LT4, however, was observed in patients after surgery.